bedbound-patient
Procedures
The patient was instructed in myelogram to lower the bed to the horizontal position to dismiss a headache. The patient was advised to take mild analgesics for insistent pain. The patient was recommended not to take phenothiazines for nausea and vomiting because these agents can increase symptoms of toxicity. The patient was recommended in the need to increase fluid drinking to improve defecation of the dye and to substitute cerebrospinal fluid.
The patient was instructed in retinal detachment in lie in the suggested position following the scleral buckling process. The patient was advised to apply cold bandages to the eye to decrease inflammation and ease anxiety. The patient was recommended to use dark glasses to reduce photophobia and pain when eye drops are used. The patient was advised to wear an eye shield at night for protection.
Medication profile reviewed and reconciled. SN reviewed and instructed patient on medication regimen of spirivia. Instructed patient that medication is used for maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD). Spiriva HandiHaler is indicated to reduce exacerbations in COPD patients. Instructed patient that, with administration of Spiriva HandiHaler, a Spiriva capsule is placed into the center chamber of the HandiHaler device. The capsule is pierced by pressing and releasing the green piercing button on the side of the HandiHaler device. The tiotropium formulation is dispersed into the air stream when its inhaled through the mouthpiece. Instructed to inhale once or twice to get al medication inhaled. Instructed patient that dry mouth or constipation may occur. Instructed to notify MD/SN right away if any serious side effects, including: vision changes (such as blurred vision, seeing halos), eye pain, difficult/painful urination, fast heartbeat.
Patient was instructed on strategies that can significantly help decrease the risk of a fall such as: Skid-proof mats or strips in the shower and bathtub, Removal of furniture that can slip away if grabbed accidentally for support, supportive non-slip footwear and not walking in stocking feet. Patient currently uses cane while ambulating and states that it helps her with her balance. Patient advised that side effects of most medications taking can cause dizziness and to report and dizziness so that it can be addressed by MD. Patient voiced understanding SN will continue to monitor.
Patient requires skilled intervention of physical therapy for exercises to increase strength and endurance, implementation of safety measures and evaluation for assistive devices due to impaired function or declining functional ability as demonstrated by increased weakness. Patient requires skilled intervention of physical therapy to teach and train patient/caregiver on exercises to increase strength and endurance, implementation of safety measures and use of assistive devices due to impaired function or declining functional ability to perform ADLs/IADLs. Patient with moderate pain interfering with functional status, thereby impacting activities of daily living.
Instructed patient that during a hurricane he/she should not be alone. Patient should go to a relative, family member or friend house until it is safe to return to his/her house. In the event that the patient has no family or friends he/she should go to the closest shelter for proper assistance.
Instructed patient that during a hurricane she should not be alone. Patient should go to a relative, family member or friend house until it is safe to return to her house. In the event that the patient has no family or friends she should go to the closest shelter for proper assistance.
Advised the patient receives complete instructions in the care of the prosthesis. Instructed patient how to apply the elastic sleeve or wrap the stump for molding and shaping. Encouraged patient that the stump should not be wrapped too strongly, since this will prejudice circulation. Encouraged the importance of daily hygiene to prevent infection and skin breakdown.
The patient was instructed to stop any anticoagulant or antiplatelet medications 1 week before the arterial revascularization surgery. The patient was advised to use antiembolic stockings. The patient with axillofemoral bypass graft was advised to evade strong use of the affected side, not to wear close-fitting or obstructive clothes (belts, suspenders) over graft site.
Instruct the patient to note the time of the first bowel movement after anorectal abscess, fistula, and fissure surgery if no bowel movement occurs or if constipation advances. Advised the patient to shave the perianal area weekly to keep hair out of the affected area. Advised the patient to sit on thick foam pillows or pads and to avoid air or rubber donuts because they spread the buttocks apart.